The Evolved Eater

by Nick Taranto

  But the human metabolic system is much more complex than what you study in a lab—and that makes a big difference. Researchers like to work with “model systems,” science jargon for a particular species that has been developed over many years to be conducive to experiments, a system that can be tinkered with to test specific theories and answer specific questions—think lab rats and fruit flies. Humans are not a model system. You can culture human cells, but nutrition is a complex thing. Studies would require re-creating the human stomach in isolation, which sounds scary and vaguely reminiscent of Krang from Teenage Mutant Ninja Turtles.

  It’s a hard problem to work on from a reductionist, scientific standpoint. How would you design a really high-end research program around human nutrition? What would be the model systems you work with? How would you run experiments? Every person is so different, and the human gut is very complicated.

  Lance also pointed to another potentially even larger issue: Where’s the funding and excitement for this kind of scientific research? The funding is not going to nutrition and wellness—it’s going to cancer and heart disease. As Lance told me, “The biology of cancer is incredibly appealing to researchers. It’s a disease driven by genetics with a clear mechanism of action and clear mutations.” The big, sexy venture capital funding goes to research on very acute human diseases, like cancer and heart disease, even though at this point it has been proven that poor nutrition leads to increased incidences of both. As a result, most of the bioengineers, big data folks, and the other hotshot scientists go to work on problems like biotech and cancer and very few of the world’s geniuses are focusing on nutrition.

  Nina Teicholz, the investigative journalist who authored a bestselling tome called The Big Fat Surprise, agrees. In the book, she writes about the “enduring problem of nutrition science: much of it turns out to be highly fallible.” At the heart of every scientific study is one goal: to measure what people eat and then follow them over a period of years to monitor their health. And, like Lance pointed out, there are a billion other factors that could be affecting their health. “While good science should be ruled by skepticism and self-doubt,” Teicholz says, “the field of nutrition has instead been shaped by passions verging on zealotry.”11

  So if epidemiology is broken, and RCTs are expensive, time consuming, and inherently flawed, and the human body isn’t a model system, and nutrition science is a murky field where data is hard to come by, and the data that does exist is often used in conflicting ways by different authors and pundits trying to make a point, then where should we turn for advice and guidance on how we should be eating? As I discovered, and I don’t mean this in a new age way, the answer lies within us already.

  The Future of Nutrition

  Within the medical community, the move to electronic medical records and the use of digital biomedical measurement devices is already transforming how doctors think and work. In addition to this formal evolution, there is an early, amateur-led grassroots movement to “quantify” nutrition and its impact. I decided to take a plunge into the world of the “quantified self” in an effort to get to the root of what and how I should be eating for an optimal life.

  I talked with dozens of biologists, cancer researchers, computer scientists, physiologists, and amateur biohackers, and I cobbled together their insight and advice to start tracking many of my own biomarkers. Through my blood, urine, saliva, and stool, I was able to gain insight into the status of major subsystems of my body. I then layered in tools to help interpret these results through the lenses of my own genome and the microbes in my gut. And in the process, I lost over thirty pounds, I dropped my body fat percentage to single digits, and I reached a level of energy and fitness that I hadn’t felt since college.

  Even though I am a far cry from a medical professional, I was able to use commercially available tests and a “systems biology integrative approach” to quantifying my nutrition and myself. I have become an early example of the American biology legend Leroy Hood’s vision of the “predictive, preventive, personalized, and participatory approach” to health care, what he called P4 medicine. This is where the future of nutrition and medicine will be; it’s not an if, but a when. However, we are not there yet, and my story should also serve as a cautionary tale of what can happen when we allow food to become nothing more than nutrition. Let’s jump in!

  Bionic Man: Dr. Larry Smarr

  I started my quantified-self journey talking about the bowel movements of a sixty-eight-year-old celebrity scientist. “Do you realize how data-rich your poop is?” Dr. Larry Smarr and I had been talking on the phone for all of five minutes, and we were already deep into his literal shit. “There are about 100 billion bacteria per gram. Each bacterium has DNA whose length is typically one to 10 megabases—call it 1 million bytes of information. This means human stool has a data capacity of 100,000 terabytes of information stored per gram. That’s many orders of magnitude more information density than, say, in a chip in your smartphone or your personal computer. So your stool is far more interesting than a computer.”12

  And Larry knows a thing or two about computers. He led a team of scientists who connected supercomputers across the United States in the early 1980s to create one of the earliest versions of what today we call the Internet. Today, he leads a futuristic research center at the University of California–San Diego, called the California Institute for Telecommunications and Information Technology, or Calit2. Over the last fifteen years, Larry has attracted almost a billion dollars in private, public, and nonprofit funding to fuel his research.

  At Calit2, Larry and his team “basically live in the future.” Larry says his eyes are focused “ten years ahead,” which in computer terms is more like a century, given how rapidly technology is transforming our world. “For instance,” he told me, “last year Facebook bought Oculus Rift for $2 billion, so now everybody is talking about virtual reality. Well, we’ve been building virtual reality facilities for over thirty years—with much higher resolution. I’m talking about walk-in rooms that are virtual reality.

  “As the takeoff to the broad-based consumer market happens, we have had thirty years of experience with how humans interact in virtual reality, how to generate content for virtual reality, how to do collaborative projects jointly across the country and the world within a shared virtual reality. So we have been living in the future of the broad consumer market for decades. That is what we like to do. And right now, we are working on the human gut and analyzing how particularly the microbiome changes with disease and with respect to food.”13

  Larry envisions a coming revolution in how we use our own bodies to practice preventative medicine, primarily through a more scientific, personalized, and quantified approach to nutrition. He is conducting a computer-aided study of his own body and has gone so far as to publish a “how-to guide” for quantifying your body “from a systems biology perspective.”14

  In Larry’s vision, we will all have “a working model of your unique corpus, grounded in your own genome, and—using data collected by nanosensors and transmitted by smartphone—refreshed continually with measurements from your body’s insides. This information stream will be collated with similar readings from millions of other similarly monitored bodies all over the planet. Mining this enormous database, software will produce detailed guidance about diet, supplements, exercise, medication, or treatment—guidance based not on the current practice of lumping symptoms together into broad categories of disorders but on a precise reading of your own body’s peculiarities and its status in real time.”15

  Larry is using his own body (what he calls his “ecosystem”) and the data it generates to prove what is possible at the frontier of nutrition, technology, and medicine. And this is not just academic, self-experimental fun: Larry used this approach—his own data plus a doctor’s advice—to diagnose a life-threatening disease before he even started feeling any symptoms.

  In 2010, Larry had already radically changed his diet. Following Barry Sears�
��s Zone Diet, he had dropped twenty pounds. While Larry was happy with this weight loss, his dieting taught him something: If you want good health, you can’t just blindly trust how you feel.

  Larry knew that he had to examine the data to get to a root cause understanding of what was happening in his body. Calit2 already had numerous grants to study “digitally enabled genomic medicine,” so in 2010, Larry signed himself up as a test subject. As he told me, “I turned my body into a genetic observatory, taking sequential blood and stool samples as often as every day. Now I’ve got over 4.5 years of data in detail. I’ve got 150 blood variables that I track every month to quarter. So for the first time, you are able to actually see how a human body tracks dynamically in terms of the underlying system variables.” As his personal quest to lose weight evolved into an effort to understand human biochemistry, his own body became the equivalent of a data-enabled petri dish.

  And something wasn’t adding up. Despite his weight loss, the data was now telling him that the pounds should still have been falling off, but they weren’t. The Zone Diet is designed to reduce inflammation, and because he strictly followed it, Larry expected his inflammation score to be low. But the C-reactive protein (CRP) score, which rises in response to inflammation, was high.

  “I had discovered that my body is chronically inflamed—just the opposite of what I expected!” he wrote in an account of his project published in 2011 in a special issue of Strategic News Service, an industry newsletter. Larry wrote, “Even more intriguing: after I had been tracking my CRP for two years, I noticed that it had suddenly more than doubled in less than a year. Troubled, I showed my graphs to my doctors and suggested that something bad was about to happen.”

  Imagine walking into your doctor’s office with a rucksack filled with printed charts, stool samples, blood vials, and a suspicion that you’re sick. The only catch is that you don’t feel sick. So your doctor tells you to go home, get some sleep, and stop worrying. Someone once asked Larry if he is a hypochondriac. “A hypochondriac is someone who imagines that they have things that are wrong with them and worries about that,” he says. “I am the opposite of a hypochondriac. I don’t make any assumptions about what might be right or wrong with me, and I don’t imagine it. I measure it.” The doctors sent Larry home and told him to come back if he actually had a problem, not a hypothesis driven from data analysis.

  This is the fundamental problem with how medicine works today: It treats symptoms. Medicine doesn’t prevent illness using rigorous data analysis. Larry was beginning to have serious doubts about his doctors. “Here’s the way I look at it: The average American has something like two twenty-minute visits a year with a doctor,” he explains. “So you have forty minutes a year that that doctor is going to help you make good decisions. You have five hundred thousand minutes a year on your own, and every one of those, you are making decisions. So we’re already in a situation where you are in charge of your ship—your body—and you are making a lot of pretty horrible decisions, or else two-thirds of the United States’ citizens wouldn’t be overweight or obese. You wouldn’t have the CDC saying that 42 percent of Americans may be obese by 2030, and a third of all Americans may develop diabetes by 2050. That’s the result of a lot of bad decisions that people are individually making on their own.”

  A month or so after his doctor sent him home, Larry felt severe pain in his belly. He returned to the doctor and was now diagnosed with an intestinal infection and prescribed antibiotics. Larry had predicted a problem using his own data, but modern medicine had fallen short. Fed up, Larry decided to take matters into his own hands.

  He requested a new colonoscopy and began testing his stool. This work led him to realize that humans are actually complex ecosystems, or superorganisms. He told me, “We are talking about insane biodiversity here. All animals that you know of—from goldfish to elephants to humans—are vertebrates, and that is a sub-biome of life on earth. Insects are a whole different biome, plants are a different biome, and so forth. There are six to eight biomes of life inside of your large intestine! So your gut is more diverse than a coral reef plus a rainforest plus an insectarium. Each one of us is a walking ecology of vast biodiversity, and we’ve only just started to understand what this means.”

  Larry’s stool samples provided information on the microorganisms inhabiting his gut, which is what Larry means when he calls his poop “data-rich.” The numbers continued to tell a bad story. They suggested that he was suffering not from an infection but from some kind of inflamed-bowel disease.

  Larry’s quest for the quantified self ultimately led him to an early diagnosis of Crohn’s disease. Crohn’s is not fatal, but it is incurable, and it comes with a bunch of symptoms that can be uncomfortable and painful. Apart from that one episode of abdominal pain, Larry was still feeling fine. But the graphs showed, and his new doctor more or less confirmed, that he was sick.

  In the near future (Larry would say the future is already here), data will help people recognize disease long before they feel sick. Doctors will move from being the CEO of your health to serving more as operational consultants or how we think of financial advisors today. Instead of being responsible for the management of your health, primarily by reacting to crises, doctors instead will analyze the data and will help plan a proactive and preventative approach, much of which will hinge on personalized nutrition.

  If all this seems far-fetched and overly futuristic, what if I told you that the early forms of this technology already exist and are being commercialized as we speak?

  Personalized Health and Nutrition

  Have you ever had a friend who swears by a particular diet only to find you barely shed any pounds when you try it? Or maybe, even worse, the prescribed diet leads you to gain weight? How could this be?

  The answer to this frustrating and confusing riddle is as simple and as complex as genetics. Our genes play a fundamental role in how the body responds to certain eating habits, meaning different individuals likely have different optimal diets, and a diet plan that helps one person lose weight may not have the same effect for another.

  For the last hundred years, “diet” has been viewed largely as something that is optimal for all people. Recent data (and common sense) indicates that different individuals need different diets for optimal health. What this means is that experts should not be giving generalized diet advice. Nutrition recommendations should be based on the genetic factors underlying different people’s individual responses to what they eat.

  For Dr. Larry Smarr, a hard-core computer scientist, the human body is the computer, and an individual’s genome is a person’s operating system. Mapping the human genome used to cost millions. Soon the price will drop below $1,000. Once people know their genetic makeup and begin thoroughly monitoring their bodily systems, they will theoretically approach the point where computers can “know” a lot more about them than any doctor ever could. As Larry told me, “In a human body, you have roughly ten times as many DNA cells that are microbes as you do human cells, and you have roughly one hundred times as many genes in the gut as you have in each of your human cells, all of which is outside of medicine and outside of nutrition.”

  In doing research for this book, I was introduced to a doctor who provides personalized nutrition and health solutions to Manhattan’s elite. When I asked if he would be willing to work with me, he literally laughed in my face. “Dude, I mean, I know you have a successful start-up and all, but almost all my clients are literally billionaires.” I asked how much his service costs, and I vomited a little bit in my mouth when he responded. He charges over $100,000. Out of pocket. Per year. On a recurring basis.

  This doctor appreciated my “poor man” plight and referred me to Health Nucleus, a different service, at a more “reasonable” price point. Health Nucleus is the brainchild of Craig Venter, the biotechnologist who instantly secured his spot as one of the most famous scientists in history when he successfully sequenced the human genome in 2000. When we talk abo
ut the dramatic reductions in the cost of human genome mapping, much of this is due to Venter’s pioneering work. I wanted to learn more.

  Health Nucleus bills itself as “a new clinical research center harnessing recent advancements in genomics—combined with a comprehensive curation of personal health history—to uncover your health risks and serve as the basis for a personalized approach to your health.” I reached out to their team and spent an hour on the phone with the Health Nucleus client care coordinator.

  He described how Health Nucleus “combines the latest technology in whole genome sequencing with a suite of state-of-the-art health assessments to provide you with a 360-degree view of your personal health.” Over an eight-hour visit at their San Diego headquarters, they conduct: a full genome sequencing, “spanning all 6 billion base pairs of DNA”; microbiome sequencing that “quantifies the collective genomes of the microorganisms that live inside and on the human body”; a brain and body MRI scan “for early detection and screening and to provide a baseline for the future”; and a “metabolome characterization which enables us to measure the products of all our biochemical cellular reactions.”

  Health Nucleus is pretty unabashed in their ambition to use data and technology to transform medicine and make it truly personalized. This feels like the version 1.0 of what Larry envisions. Once they have conducted their eight-hour visit and developed a baseline assessment, Health Nucleus provides you with ongoing health advice to help you understand how new genetic risk associations, medical discoveries, and treatments impact your unique profile. They then work with you and your doctor to develop prevention plans (including nutrition) to solve problems before they even start.